Jane Ellison: Further to the Minister’s reply, will she respond specifically on female genital mutilation, which is a significant problem in this country as well as in the developing world? The Metropolitan police are taking it very seriously, but hundreds of women in London alone present every year with appalling complications associated with pregnancy and childbirth. Can we make this matter a priority, and work with all the agencies and charities to eliminate that abominable practice?

Damian Green: This is an important point because, when we proposed this radical change the universities were understandably worried. Following our announcement, however, we have received overwhelmingly positive feedback from the university sector. Indeed, Universities UK has said that the reforms
	“will allow British universities to remain at the forefront of international student recruitment.”
	I am delighted that the policy has been so welcomed by the sector.

Nick Herbert: I strongly agree with my hon. Friend. Staffordshire police are a very good example of a force that has taken the decision to make savings while protecting neighbourhood policing. In so doing, they are ensuring the continuation of that visible presence that the public value.

James Brokenshire: Clearly, antisocial behaviour is, at its core, a local issue, so it lends itself to local solutions. As 10,000 incidents are reported every day, I doubt whether any Member will not have a constituent case
	that touches on the subject. The powers on which we are consulting until 17 May are very much about local communities and equipping local agencies to deal with the problems they see, trusting their judgment to get on with the job.

Sarah Wollaston: In England alone, about 36 children every day are admitted to hospital as a result of alcohol-related harm. Will the Home Secretary consider making the reduction of alcohol-related harm an objective, and prioritise it in respect of licensing decisions?

Theresa May: My hon. Friend’s question enables me to say how strongly we support CEOP’s work. We want it to be a lead law enforcement body in terms of protecting children nationally, so I am pleased to announce that it will form part of the new national crime agency and will continue to build on the work it is doing. In examining the issue of grooming, it is important to wait for CEOP’s thematic report, see the extent of this problem and, obviously, take CEOP’s advice on any action that needs to be taken in relation to particular communities, but I do not think we should see this as an issue that relates only to particular communities.

Theresa May: As I have previously informed the House, the first duty of government is to protect the public. Following the death of Osama bin Laden, the overall threat level from international terrorism remains at severe and there is a continuing need for everyone to remain vigilant and to report suspicious activity to the police. Last week’s verdict from the coroner’s inquest into the London bombings on 7 July 2005 reminds us of the real and serious threat from terrorism. I have made a written ministerial statement on the verdict this morning. Across government, we are carefully considering the
	current recommendations and we will respond in due course, at which time I would expect to make a further statement to the House. Nothing will ever bring back the 52 people who were murdered on that day, but I hope that the comprehensive, open and transparent inquests that have been held have brought some measure of comfort to the families and to all those affected.

Theresa May: I assume that the hon. Gentleman was speaking about the police, although I do not think the word passed his lips. He asked whether any Minister can get up and not make reference to the mess that we were left by the previous Government. The reason why savings are being requested from police forces, and the
	reason why across government we are having to make cuts in public sector spending, is the deficit that we were left by the Labour Government. Had Labour been in government, it would be cutting £7 for every £8 that we are cutting. The issue for the hon. Gentleman and his right hon. and hon. Friends is where they would make those cuts.

John Robertson: Can the Minister say a little more about how happy the universities were about the new visa system, and in particular what he would say to Glasgow Caledonian university, which has been suspended from sponsoring foreign students and had a 28-day suspension imposed on it? What would he say to the university, which finds the situation difficult and the sentence disproportionate?

Theresa May: This is not the end of the story. Indeed, we are working in a number of ways to ensure that we continue to cut police bureaucracy. My right hon. Friend the Minister for Policing and Criminal Justice is looking at savings in bureaucracy that can be made across the criminal justice system. Chris Sims, the chief constable of West Midlands police, is the ACPO lead on reducing bureaucracy and is looking at other ways of reducing bureaucracy. Sara Thornton, the chief constable of Thames Valley police, is looking to reduce the 600 different
	guidance documents that the ACPO provides to police forces to fewer than 100. Those examples show that this is work in progress, but our commitment is absolutely clear.

Anne Begg: Now that the Aberdeen passport office has closed, my constituents face a long journey for a face-to-face interview about their first passport. They are expected to travel to Dundee, 70 miles away, but, because of the extra work caused by the closure of other offices throughout north-east Scotland, they have now been told that they will have to
	go either to Edinburgh or even to Newcastle. It appears that the alternative arrangements that the Government promised have not been put in place, so will the Minister look at the issue to make sure that they are put in place and it is not impossible for my constituents to get a passport?

Thomas Docherty: On a point of order, Mr Speaker. Recently, the Procedure Committee published its eagerly sought report on hand-held electronic devices and tweeting in the Chamber. Could you update the House as to whether that report has simply been accepted as a new procedure for the House or whether we will have a full debate on the matter and a vote?

John Healey: My hon. Friend gives good service on the Health Committee and follows the details of the matter more closely than most in the House. He has an important point, because the quality of health services for patients is inevitably affected by the deep and fast cuts in other areas. One need only look at the problem that people in local authorities are having in continuing to provide good social care, which is causing problems for the people who depend on that care and for the NHS.

John Healey: The point about the Health Secretary’s legislation is that it allows consortia to outsource in whole the job of, not the responsibility for, commissioning. He made the point that the consortia are public bodies, but they meet none of the standards of public governance. They can meet in private. As the right hon. Member for Charnwood (Mr Dorrell) has said, that serious job should be done by properly constituted and governed public authorities, but that is a loophole in the legislation.

John Healey: My hon. Friend puts the position and the challenge, especially to the Lib Dems, very clearly. The challenge to Conservative Members is this: they must recognise that the Prime Minister made the NHS his most personal pledge before the election. People wanted to believe him, but in just one year, the NHS has become his biggest broken promise. My hon. Friend mentions the pause. In our Opposition motion in March, we urged the Government to
	“pause the progress of the legislation in order to re-think their plans”.—[Official Report, 16 March 2011; Vol. 525, c. 374.]
	The Health Secretary dismissed that, but he has now been told to do so by the Prime Minister.
	However, many of the signs point to the Prime Minister’s “pause to listen” being a sham. Just one week after the announcement, and in fact on the day that the Health Secretary received that historic vote of no confidence at the Royal College of Nursing, the NHS chief executive wrote to NHS managers to tell them that
	“we need to continue to take reasonable steps to prepare for implementation and maintain momentum on the ground”.
	The House is used to pre-legislative scrutiny, but not pre-legislative implementation.

John Healey: The hon. Gentleman has great expertise in, and commitment to, cancer care. He is right that our survival rates continue to lag behind parts of Europe, but I am sure he is aware that the rate of fall in deaths from cancer has accelerated in the past decade. On that basis, and with continued investment and reform, we have a chance of catching up to European levels. However, the reforms proposed in the Bill, as many cancer charities and those who represent patients testify, raise the concern that the great gains made by the cancer networks in integrating and co-ordinating services for cancer patients and sufferers will be put at risk.

John Healey: I am going to make progress now.
	The NHS chief executive described the NHS reorganisation as
	“enormous—beyond anything anybody from the public or private sector has witnessed”.
	He is right. At this time of tight finances, the Government are piling on extra pressure and putting the NHS at risk with this reorganisation. The Health Committee warned in January that the NHS efficiency challenge was
	“already a high-risk strategy and the White Paper increased the level of risk considerably”.
	Now nearly £2 billion that was promised for patient care is being held back to cover the cost of reorganisation, and hospitals are being forced to cut back on costs by one third over the next five years, as all are forced into foundation status by 2014.
	I was in Wigan this morning, where the chief executive of the hospital trust told me that the hospital must make £14 million in cost savings this year and similar
	amounts the following year. He described that as an almost impossible task. More importantly, however, it puts at risk the strategy for better services and better value for money, and the strategy for more integration of hospital and community services. He said of the Government’s plans that the sheer distraction of reorganisation and insistence on competition will scupper our chance of doing that.
	The pressures of this high-risk reorganisation are one the reasons that just one year into this Government, patients are starting to see the NHS go backwards again under the Tories, with waiting times rising, operations delayed, services cut back and front-line jobs lost. This is not just a problem with the timing or pace of change, however, and nor is it a problem of presentation. In fact, the closer people look at the plans, the more concerned they become, which is why there is growing criticism of the Tory plans for the NHS from doctors, nurses, patients’ groups, NHS experts, the Health Select Committee, peers in all parts of the House of Lords and now even the Lib Dem leader. The closer people look, the more fundamental and far-reaching they see these changes to be.
	Today, the Royal College of General Practitioners warned the Prime Minister that his health Bill undermines our comprehensive health care system and will cause “irreparable damage” to the core values of the NHS. So far Ministers have branded such criticisms as scaremongering, but people in the NHS are already starting to see this happen. The Government’s first act was to remove national waiting time standards—the patients’ guarantee that they would be seen and treated quickly—which the Health Secretary described as “clinically unjustified targets”, but the patients do not see it that way, and nor do the surgeons. The president of the British Orthopaedic Association described the delays now being faced by patients as “devastating and cruel”.
	The NHS Bill takes the break-up of our NHS still further. National Institute for Health and Clinical Excellence decisions on what drugs or treatments patients should have on the NHS become optional for commissioning consortia, and for the first time since 1948, the Secretary of State will not be responsible for delivering a national health service or for defining its scope. In future, the power to decide what health services will be provided free at the point of need—as now—and what further services will be charged for will rest with the new commissioning consortia. That was the basis of the concern expressed today by the Royal College of General Practitioners. These consortia will be able to meet and take decisions in private, and to outsource commissioning to private companies; but they will not even need to have a GP on their board—in fact, they will not need to have a board at all.

Gisela Stuart: Will the right hon. Gentleman give way?

John Healey: I will not.
	It is not the five clauses that set up the GP consortia that cause the most concern. It is the 85 clauses that set up the NHS as a full-scale market, and it is part 3 of the Bill, which opens up all areas of the NHS to private health companies; removes requirements for proper openness, scrutiny and accountability to the public and to Parliament; allows NHS hospitals to go bust and face a commercial insolvency scheme; places the judgment of the new competition regulator—just like those for gas and electricity—at the heart of decisions about the future of the NHS; and, for the first time, makes the NHS subject to the full force of UK and European competition law. That means that, in the long term, we will see clinical planning in the NHS being replaced by market competition, service integration being replaced by corporate cherry-picking, public accountability being replaced by commercial confidentiality and the public ethos at the very heart of our NHS being replaced by the profit motive.
	I agree with the Deputy Prime Minister that no Bill is better than a bad one, but I say to him that this is a bad Bill. That is why we have opposed it from the outset, and that is why we say that it must be shelved in its current form and that radical changes must be made. For us, for the NHS and for NHS patients, this is the test of the Prime Minister’s promise to protect the NHS. I commend the motion to the House. [ Interruption. ]

Graham Stuart: The shadow Secretary of State is a decent man and an experienced Minister. The reason why his speech was so weak is that he had no conviction because he has been forced by the union paymasters of the Labour party and of the shadow Leader of the Opposition to deliver the sort of speech previously given by the far left who inhabit the Benches way over there. My right hon. Friend should not listen to those voices; he should press ahead and make a difference for patients, not politicians.

Andrew Lansley: I agree with my hon. Friend that the shadow Health Secretary is a decent man, and at the turn of the year, he quite decently expressed his support for the Bill’s principles and his understanding that it was consistent, coherent and comprehensive. It makes one wonder what has happened to him in the interim. Did the trade unions—the paymasters of the Labour party—get to him and tell him that they did not like the idea that patients should be able to get the care they need or the idea that we should get resources into the front line rather than into the vested interests of the NHS?
	What we are going to do is put patient care at the heart of our reforms. We are not going to let hospital productivity continue to decline as it did over the last decade. Under Labour, we saw a 15% decline in productivity, yet we heard nothing from the shadow Health Secretary about that. It is this Government who are taking action to improve hospital performance by changing the way hospitals are paid to reward excellence—for example, by not paying for unnecessary readmissions of patients who are discharged too soon.

Andrew Lansley: My hon. Friend makes an important point—that it was under the Labour Government that many of these projects were undertaken, and they are leaving an enormous bill in the NHS for future taxpayers and future NHS organisations to meet. A contract is a contract, as the right hon. Gentleman and the House will understand, and we inherited contracts from the Labour Government, many of which were very bad contracts, such as the ones on IT that we have had to renegotiate. Frankly, it is due to my right hon. and hon. Friends in the Treasury and ourselves at the Department of Health that people have been put into the Queen’s hospital in Romford to look at how we can resolve some of these PFI problems and reduce those costs. We need to increase productivity in the NHS and cut out much of the waste in it.
	It is us who will usher in a new era of transparency into the NHS, shedding light on those areas that the previous Administration sought to cover up. Before the
	election, how often were patients having to go into mixed-sex accommodation when the rules on single-sex accommodation were breached? We did not know, because when Labour Members were in government they would not tell us. Since we started publishing the data in December, the number of patients put into mixed-sex accommodation without justification has halved.

Andrew Lansley: I will give way in a moment. That strategy made clear that what matters to patients is not only how quickly they see a consultant, but whether they survive.

Gordon Birtwistle: Will the Secretary of State confirm that the meeting patients’ needs programme put forward by the previous Government, which closed down many accident and emergency units and many children’s wards, will not happen again under this new regime? Will he confirm that that is because local people and local GPs will be consulted first, as opposed to having the programme driven through with no support and no consultation, as was done under the previous Government?

Andrew Lansley: Yes, I can. Some 220 pathfinder consortia have come forward, representing the equivalent of 45 million patients across England—that is, 90% of the population. They are not obliged to do so. They have volunteered to come forward to demonstrate that they can deliver better services for patients.

Andrew Lansley: Thank you, Mr Speaker.
	The principles we are pursuing are simply stated as
	“a greater role for clinicians in commissioning care, more involvement of patients, less bureaucracy and greater priority on improving health outcomes”.
	The right hon. Member for Wentworth and Dearne will no doubt recognise those words, because they are his own from January, when he said that he supported the general aims of our reform.
	We are already delivering on our vision. We are extending patient choice and involving patients more in decisions about their care. We are cutting back Labour’s waste and reducing the bureaucracy that stifles and undermines doctors and nurses. We are putting clinicians at the heart of commissioning, with almost 90% of the country now covered by new pathfinder consortia.
	We are driving down hospital-acquired infections, sustaining and improving the performance of the NHS, stopping Labour’s arbitrary box-ticking and focusing on the outcomes that matter. We have a world-leading framework for the results that matter to patients: reducing avoidable mortality; enhancing recovery after treatment; improving quality of life for those with chronic conditions; maximising safety and cutting the number of infections; and continually improving patients’ experience of their health care. Those are the outcomes for which we and the NHS will be accountable.
	Let me be clear: there will be substantive changes to the Bill to deliver improvements for patients. There is only one issue for me, however: will it deliver better care for patients? That is why we will pursue NHS modernisation and why we will stick to our principles. It is why we are listening to improve the Bill. That is what the coalition Government are committed to. Today, led by the NHS future forum, we are engaging with the health service and beyond to ensure that the legislation delivers on those principles.
	Unlike the Labour party, which has retreated to its union-dominated, regressive past, we will not retreat. We will be progressive with those principles. Just last week, the right hon. Gentleman called for a return to Labour’s top-down targets and for GPs to be stripped of all their financial responsibility. He has called for the NHS to be a run by a bureaucracy, not by doctors and nurses. Critics of the Bill must answer this question: if they do not want patients, doctors and nurses to be in charge of the NHS, then who do they want to be in charge?
	The right hon. Gentleman has turned his back on two decades of NHS modernisation. We will never accept the Labour party’s prescriptive, top-down bureaucracy or its waste. We did not accept Labour’s plan, which would have meant taking £30 billion out of the NHS in England over this Parliament and we will not follow the route that the Labour party in Wales has taken, where it is cutting the NHS. Instead, we are increasing the NHS budget over this Parliament by £11.5 billion. We will equip the NHS to deliver better and improving services by using more resources more effectively. We will empower patients with information and with choice. We will empower doctors and nurses to shape services for their patients. We will bring together the NHS, public health and social care in a combined local strategy. We will make the NHS genuinely locally led, while meeting national standards. We will focus relentlessly on the quality and outcomes we achieve for patients. We will protect the NHS and strengthen it. We will do that not by living in the past, but by modernising for the future. We want a modern service that is true to its core values. The Labour party’s motion offers no future for the NHS. We on the Government side will give the NHS a stronger future, and I urge the House to reject the Labour party’s motion.

Dan Jarvis: The national health service is about people—those who work in the NHS and the patients for whom they care. It produces
	heroes on a daily basis. In the last year, I have spent long nights at my late wife’s bedside as she battled against cancer. I am reminded of Andrew Agombar, the consultant surgeon who twice operated on my late wife, and of his relentless commitment to trying to save her and to serving the public. I am reminded of the conversations I have had in Barnsley hospital with doctors and nurses. I am reminded of the GPs who provide an integral part of the British way of life and I am reminded of the porters, cleaners and volunteers. They are all heroes and are all dedicated to the very best principles of our NHS.
	In my family’s darkest days, we saw the true genius of the NHS—a genius based on care and compassion, commitment and dedication, principles and standards. The market can be a useful tool, but there are limits to its ability to deliver those values. There is a reason why Bupa does not do accident and emergency, and we must never allow an ideological free-market agenda to undermine all that is great about the NHS. That is what the Government are in danger of doing. I accept the need for fiscal responsibility and I acknowledge that the Secretary of State’s proposals have the purpose of moving health care more into the community and away from hospitals, but the patient, not the market, must always come first. The risk is that the British people will pay for these reforms three times over while patients see little or no improvement in their care.
	The previous Labour Government delivered the biggest hospital-building programme in NHS history based on private finance initiative funding, which the then Opposition supported. Consequently, many trusts are now locked into 20 to 30-year fiscal plans. In order to realise the benefits of the investment that Labour put into the NHS, those trusts will require stable funding over this period. Without it, much of the existing investment could be wasted.
	GP commissioning is another example of the Bill’s inefficiencies. The taxpayer could end up paying to fund the community or the private investor.

Dan Jarvis: Although I am new to this business, if hon. Members and the Secretary of State had such faith in the reforms, it is confusing to me why they were not put in the manifesto and the people of this country given the opportunity to vote on them at the general election.
	GPs will be substituting the calculator for the stethoscope. That is bad for the NHS and bad for patients. Given how far we have come, would not the first year of the Secretary of State’s tenure in the Department of Health have been better spent, for example, on a concentrated investment of effort in cancer care? We must fight the war on bureaucracy, but not at the expense of the war on cancer.
	Would not the Secretary of State have better spent his time learning from our European partners how to educate our constituents about the dangers of an unhealthy lifestyle—diet, drink and drugs—and their effect, particularly with regard to cancer treatment? We need to address the reasons why a cancer sufferer in Barnsley is less likely to survive than a sufferer in Barnet. These are the NHS reforms that would make a positive difference and that the country expects us to deliver. Instead, in my constituency, the scale and pace of the Government’s cuts are making it virtually impossible for Barnsley hospital to plan ahead. Budgets are being cut while patient numbers are going up.
	The Government are proposing the biggest reorganisation of the NHS since its inception—

Dan Jarvis: I have almost finished so I shall keep going.
	The reorganisation is one for which the Government have no mandate. That raises the question, as I said, whether the Secretary of State deliberately chose not to
	include these drastic reforms in the manifesto because he knew how unpopular they would be. The NHS is the pride of its staff, its patients and our country. We all deserve better.

Emma Reynolds: Does the right hon. Gentleman agree that it would have been possible to make the current structures work better? The coalition agreement states, on page 24:
	“We will ensure that there is a stronger voice for patients locally through directly elected individuals on the boards of their local primary care trust”.
	It is possible to democratise better the PCTs and give greater clinician involvement in them, so does he support some of the calls from the professionals to keep the cluster PCTs?

Stephen Dorrell: I want to make my speech in my own way. The hon. Lady asked at the beginning of her intervention whether I agree that it would have been possible to introduce quite a lot of this without the need for a long Bill. She does not need to put that question to me, because the Health Secretary made the same point during the last health questions. We are seeking in the Bill to provide a holistic basis—a structure for the health service going forward, and that is an objective, starting from where we are, that it seems entirely reasonable to embrace.
	I was seeking to identify the problem that my right hon. Friend’s measures must be designed to tackle, because as he and the Prime Minister have said repeatedly, no change is not an option. That should not be a matter of party political debate because the definition of the core problem facing the health service can be found in the NHS annual report for 2008-09, which was published 12 full months before the general election. I quote from it a single sentence:
	“We should also plan on the assumption that we will need to release unprecedented levels of efficiency savings between 2011 and 2014—between £15 billion and £20 billion across the service over those three years.”
	That is what we on the Health Committee referred to as the Nicholson challenge, because it was first articulated in the chief executive’s report a full 12 months before the election. That is the challenge that my right hon. Friend has to address, because it is the inescapable challenge in front of the national health service.
	In point of fact, my right hon. Friend has made the challenge rather easier than it was in the days of the previous Labour Government, because there is a commitment to real-terms growth in the health budget throughout this Parliament, and because he has given the health service four years to respond to the Nicholson challenge, whereas the original articulation was focused on the three years ending in 2014.
	But, the substance of the need to deliver unprecedented efficiency gains out of the health service is the constant between the previous Government and the current Government. The articulation of it in the chief executive’s report was “£15 billion to £20 billion”; I have always preferred to articulate it as, “4% efficiency gain, four years running”.
	That is what the health service has to deliver against the background of it never having delivered 4% efficiency in a single year, and of no health care system anywhere in the world having delivered a 4% efficiency gain, four years running. So, Sir David Nicholson, 12 months before the general election, was 100% right to say, “This is an unprecedented challenge,” and the challenge was embraced by the previous and current Governments.

Grahame Morris: I pay tribute to the thoughtful contribution by the right hon. Member for Charnwood (Mr Dorrell), who chairs the Select Committee on Health.
	I come to this debate as, I believe, one of the longest-standing opponents of the Bill, both as a member of the Health Committee and as a member of the Health and Social Care Bill Committee. As such, I have consistently raised serious concerns about not only some of the detail contained in the Bill but the direction of travel charted by these reforms since they have developed from manifesto to coalition agreement to White Paper, and finally morphed into the Bill itself. I have become accustomed to the protestations and rebuttals of Health Ministers on every issue that I have raised, so I am somewhat sceptical about the listening exercise.
	Those issues include the pace and scale of reform, the lack of a credible large-scale pilot to assess the impact of the changes, the conflicts of interest inherent throughout
	the Bill, as identified in the Channel 4 “Dispatches” TV documentary, and the threat of privatisation by stealth.
	[
	Interruption.
	]
	Despite the protestations and groans of Government Members, there is nothing in the Bill to rule that out. I can cite some examples, not least in relation to the prison health contract that was recently awarded to Care UK to provide health services for eight prisons in the north-east of England, resulting in 120 NHS staff being displaced and made redundant. There is a clear and present danger of privatisation of the service.
	Perhaps the strongest advocate of the Bill, as it stands prior to any changes, has been the Minister of State, Department of Health, the hon. Member for Sutton and Cheam (Paul Burstow), who is no longer in his seat, and who was the Lib Dem steward of the Bill in Committee. On 10 March, he said in an interview in The Guardian:
	“This is a change that liberals can embrace.”
	On 17 November, in the Commons Chamber, he called Labour’s record on the NHS a “failed status quo” and wholeheartedly backed the Tory NHS reforms. This year, we found out that the Department of Health had at that time been trying to suppress an internal IPSOS Mori poll of public satisfaction with the NHS. That is interesting, because the poll shows record levels of public satisfaction. Perhaps even more disturbing are rumours that next year the Department intends to cancel the commissioning of such a survey. Rather than saying that Labour has failed on the NHS, the survey showed the highest ever levels of public satisfaction.
	An even bigger supporter of the Bill, until now, has been the Deputy Prime Minister. On 23 January this year, on the “Andrew Marr Show” he was asked by Mr Marr, of the Health and Social Care Bill,
	“Was that in the Liberal Democrat manifesto?”
	The Deputy Prime Minister responded:
	“Actually funnily enough it was. Indeed it was…I agree it’s an ambitious programme of reform—but over time I think it’ll leave patients with the feeling that they are at the centre of it.”
	I am slightly perplexed by the hasty posturing and sudden synthetic explosion of anger by senior Liberal Democrats in the coalition, perhaps in the wake of the meltdown following last Thursday’s elections. I take those criticisms with a pinch of salt.

Sarah Wollaston: I have no doubt that one of the main reasons why I was elected to the House was because I promised to bring my clinical experience to bear on the health debate and to stand up for our NHS. I would therefore like to set aside party politics for a moment and give my personal take on the direction that I hope the proposed reforms will take and where we should go from here.
	At the heart of the Bill lie issues of choice, competition and clinical commissioning. My right hon. Friend the Member for Charnwood (Mr Dorrell) set out clearly the huge funding challenges that face the NHS. We have always had rationing in the NHS, but we are squeamish about discussing it. In an ideal world with unlimited resources, unrestricted choice would of course be a good thing, but it is not deliverable. Because of the limited budget, we need to focus on getting the very best value while openly and honestly involving communities in how we do that fairly. If that happens locally, one person’s local commissioning becomes another person’s postcode lottery.
	The central problem with unrestricted choice in the form of the “any willing provider” model is that it forces commissioners to act as bill payers and has the potential to undermine good commissioning. What is the point of commissioners designing high-quality, locally responsive clinical pathways that deliver good value for money for the whole community if patients have a free choice of any willing provider and commissioners have no choice but to write the cheques?

Valerie Vaz: It is always a pleasure to follow the hon. Member for Totnes (Dr Wollaston) and to serve with her on the Select Committee on Health.
	I welcome this debate, which is the first chance that the House has had to debate the NHS after the pause—the listening, reflecting and engaging exercise—since Second Reading of the Health and Social Care Bill. Something about this debate made me think of the words of The Beatles song “Hello, Goodbye”. Madam Deputy Speaker, you can imagine the discussion in No. 10 between the Secretary of State for Health and the Prime Minister: “You say stop, I say go. You say, ‘Why?’ I say, ‘I don’t know.’” I promise it sounds better when sung. We can see now why The Telegraph said this Saturday that the Secretary of State was to get first aid from the No. 10 spin doctors.
	It is right that the Government should take on board the voices in this House and outside—those of the experts, the patients, our constituents—not in reselling their proposals, but in fundamentally changing them. I wish to cover three main areas: accountability, costs and other concerns. On accountability, as a member of the Health Committee, which is so ably chaired by the right hon. Member for Charnwood (Mr Dorrell), we have heard evidence from expert after expert—from the BMA, which I promise was not whingeing, to GPs, nurses and public health clinicians—all of whom expressed concerns about the lack of detail on the ideas in the White Paper. Matters did not become much clearer even on Second Reading.
	Our latest report, “Commissioning: further issues”, published on 5 April, said that there should be no doubt that the Secretary of State has ultimate responsibility,
	but that is not clear from the Bill. We have concerns about accountability and the governance arrangements for the consortia that will be responsible for £60 billion of public money, but that issue is not clear in the Bill. There are concerns that private and voluntary providers will not be covered by Freedom of Information Act 2000, which is not dealt with in the Bill either. Concerns remain about conflicts of interest in respect of GPs who are commissioners and providers, but that is not clear in the Bill.
	Some PCTs were working with clinicians to provide a more integrated service. A more evolutionary and cost-effective approach would be to remove the non-executive directors of the PCT boards and replace them with GPs. That would have been not a top-down reorganisation, but a progressive and less disruptive approach.
	I am staggered by the uncertainty surrounding how much this reorganisation will cost the taxpayer. The proposals in the White Paper were neither costed nor explained, and the spending is not committed, so it must come out of revenue. Professor Kieran Walshe, of Manchester Business School, put the cost at £2 billion to £3 billion, but the Government’s figure is £1.4 billion. The redundancy costs alone amount to £852 million. Sir David Nicholson said that the running-cost envelope was £5.1 billion for the running of the current service and the development of the consortia. In an written parliamentary answer to me, the Minister said that the spend and operational arrangements of pathfinder consortia are not being monitored. That smacks of fiscal incompetence and a Department that has lost control of its budget. It is so out of control that the head of Monitor wrote to foundation trusts, telling them that the NHS must find savings of 6.5% rather than 4%. That is an extra £1.1 billion on top of the savings demanded by the Department.
	Members will be interested to know that the head of Monitor compared the NHS under the Government’s proposals to privatised utilities. Does Ofgem have trouble regulating the utilities? It was ineffective in dealing with companies’ unfair pricing practices and companies that made large profits during the recent severe weather.

Dawn Primarolo: Order. A large number of people still wish to speak, and we simply will not get everyone in unless I reduce the time limit further, so that is precisely what I am going to do. The time limit for contributions to the debate from Back-Bench Members is now five minutes.

Debbie Abrahams: It is a pleasure to follow the hon. Member for Southport (John Pugh). A lot of water has passed under the bridge since the middle of March, when we last debated the NHS. The Committee tasked with scrutinising the Health and Social Care Bill, on which I served—a baptism of fire—finished its deliberations at the end of March. I believe that it was the longest running Bill Committee since 2002, so it was a marathon stint in which we debated 280 clauses and 600 amendments. During those eight weeks, the Government did not accept a single amendment. Some hon. Members made exceptional speeches, dissecting the Bill in detail and arguing against it. I remember in particular a debate about regional specialist services and how they would be commissioned in future. I am afraid, however, that that was as far as it went when it came to changing the Bill. I was therefore nonplussed when, the day after the Committee finished its proceedings, the Prime Minister and the Deputy Prime Minister expressed their concerns about the Bill and announced a pause in its enactment.
	At the same time as the Public Bill Committee was sitting, we saw growing public anxiety about what the Bill would mean to patients and their families. I was contacted by hundreds of my constituents and received a petition signed by nearly 300,000 people from across England. Perhaps that was the motivation for the Government’s change of heart or was it just political rhetoric, with the elections looming? There has certainly been no pause in NHS reorganisation in many areas, including my own, where, as I mentioned the other week, it has actually been brought forward.
	The public are beginning to see an erosion of the considerable improvements made in the NHS under Labour, and this is what is fuelling public concern. In Greater Manchester, as Peter Thornborrow, one of my constituents found out to his cost, there are much stricter criteria for cataract surgery, as is also the case for hip and knee replacements.

Debbie Abrahams: Does not the hon. Gentleman think that that is why we won the election in Wales?
	The savings required are 4%, and if the Government get their way with the new economic regulator Monitor, they could go as high as 7% each year—far more than our NHS is capable of coping with.
	In my constituent Peter’s case, he was refused a cataract operation, yet his vision was so poor that he was able to see the world only through a haze; as a precision engineer, furthermore, he was not able to do his job and faced the threat of redundancy. In other cases, non-compliance with NICE guidelines—on familial hypercholesterolaemia, for example—is leaving people at extreme risk of untreated cardiovascular disease.
	Health professionals have almost without exception castigated the Bill for what it will do to the NHS in completely opening it up to the market with competition law applying in full and allowing private health care providers to cherry-pick profitable services. A hospital medical director said last week that he did not know how his hospital could continue to provide care for unprofitable patients.
	The unprofitable services for most hospitals are elderly care, mental health, paediatrics and maternity, which are essential services for all communities. Instead of service providers and commissioners working together to provide the best quality care they can for their patients, the trend is for hospital trusts to maximise income and compete against each other. We are already seeing that lack of co-operation when PCTs look at alternatives in commissioning. Trusts are reluctant to collaborate when they see that it might reduce their income, even if it improves the quality of patient care. Similarly, the Bill gives GPs a financial interest in restricting or refusing treatment in order to make savings and to get bonus payments from the NHS commissioning board.
	Labour wants genuine savings that will enhance patient outcomes rather than produce the diminishing effect that we are currently seeing, and we believe that we can
	achieve that. We want hospital specialists and GPs to work together to deliver clinical care pathways that improve the quality of patient care and bring care closer to home. One local PCT is trying to introduce the use of drugs that are cheaper—and unlicensed—to treat age-related macular degeneration, but it is under severe pressure from the pharmaceutical industry. That is another way in which we could reduce costs.
	There is no doubt in my mind that, unamended, the Bill threatens the founding principles and values of the NHS. It removes the duty to provide a comprehensive health service, and provides an opportunity for the new NHS commissioning board and GP consortia to charge for services. It involves a costly, ideologically driven reorganisation of the NHS that has no mandate from the British people, no support from health professionals and which will mean the end of the NHS that we know and love. As I have said before, the NHS is not just an organisation that plans and provides our health care; it reflects the values of our society on which this country set such store.
	I know that there are many members on this side of the House—

Tony Baldry: When in government, the Labour party acknowledged that the NHS would have to make considerable efficiency savings over the next few years. My right hon. Friend the Member for Charnwood (Mr Dorrell), the Chairman of the Health Committee, has described that as the Nicholson challenge. The more I listen to speeches from Opposition Members, the more I am convinced that their opposition to the Bill is a cynical exercise. Given the Nicholson challenge, if at any time any hospital gets into difficulty, the Opposition will simply say, “That’s a consequence of the health reforms.”
	All of us in the House want to ensure that we get the health reforms right. I suspect that for all Members of Parliament the NHS in their own constituencies is one of the most important political and, indeed, constituency issues, but for me one of the main issues was, for much of the last Parliament—and still is—the need to retain the full range of services at Horton general hospital in Banbury. If there are difficulties in the NHS, it is hospitals such as the Horton that will experience them first. It is therefore imperative, for me, that we get the reforms right, but I have every confidence that the Secretary of State and his ministerial team will get them right.
	The Secretary of State, the Minister of State, Department of Health, my right hon. Friend the Member for Chelmsford (Mr Burns), and pretty well every other health Minister has been to Banbury to visit the Horton. As the Secretary of State made clear to GPs in Banbury not so long ago, GP commissioning enables GPs to put their confidence in their local hospitals by commissioning services for them. In my county we will be replacing an Oxfordshire-wide PCT with an Oxfordshire-wide GP-led commissioning body, with GPs in the county working collaboratively.
	In the brief time that I have in which to speak, I want to make two points to Ministers. The first is this. While I am sure it is right for us to pause and listen, we should also recall that GPs are keen to get on with this task. I have had public meetings in my constituency which have been open to every GP on my patch, and the message that I have received from them is that they want to be catalysts for change: they want to be able to shape health services in Oxfordshire.
	GPs throughout the county recently elected Dr Stephen Richards to lead the development of the Oxfordshire GP consortium. His first comment was this:
	“GP practices are the bedrock of the NHS. Now, the whole GP community, from partners and sessional doctors through to GP trainees are in a unique position to reshape health care for the population of Oxfordshire.
	The new Consortium Lead and the Locality Leads in OGPC”—
	the Oxfordshire GP consortium—
	“will have much greater influence over the improvement of patient care. These GPs will be accountable to their GP colleagues”
	and
	“to the public... I aspire to Oxfordshire leading the way in developing ‘Evidence Based Commissioning’. A new form of commissioning that offers contracts based on incentives and agreed improved patient outcomes.”

Frank Dobson: The current situation is extraordinary: the Liberal Democrats originally denied our criticisms of the Bill, but they have now suddenly jumped on board, and all I can say is that they are very welcome.
	Both Lib Dem and Tory Ministers have claimed that the NHS is a failure, and the Secretary of State said today that he had inherited Labour’s mess. Labour’s mess was to leave the national health service in the best situation it has ever been in: more successful than ever before and improving rapidly, with waiting lists and waiting times reduced to the lowest they have ever been, and with massive improvements in survival rates. From listening to Opposition Members, people would never imagine that when we came to power 5.9 million operations were being carried out in NHS hospitals, yet when the current Government came to power we—or, rather, the people working in the national health service—had increased that to 9.7 million, which is a rise of 64%. For instance, the number of cataract operations carried out each year had increased from 165,000 to 246,000.
	There have been massive improvements, and I personally do not give a toss what the OECD says. The national health service is more cost-effective than practically any other system, and it achieved that by making many different sorts of local changes—not structural changes, but by people going about their professional business trying to do things better. The Labour Government facilitated that in a body that is essentially co-operative in its organisation, ethic and culture. That is because it is based on the pooling of costs: all of us pay in, and if we get ill we get treated without having to pay. That is not going to happen any longer, because under the Bill’s provisions both the commissioning bodies and the hospitals will be able to decide to charge for some of the services that are currently free. The new chief executive at the Whittington hospital has told us all that.
	There is not just a pooling of cost and risk in terms of patients. There is a pooling of risk and cost across the national health service, so that these co-operative organisations share the costs of providing treatment and care. That will not prevail if they are forced to compete with the private sector because, as the hon. Member for Southport (John Pugh) pointed out, the first, and only, legal priority of private sector organisations is to look after the interests of their shareholders. They will therefore concentrate on creaming off the profitable work, leaving the national health service to try to provide the services that are too expensive for the private sector.
	I did not support the bits of privatisation that the previous Labour Government introduced so, unlike the Tories, I have been consistent. UnitedHealth took over three GP practices in my area not that long ago and that American-based company has just sold those three franchises to another supplier without any consultation with local people, patients or staff. It regards its function as taking part in a commercial set-up and a commercial transaction, and that is what we face if this Bill goes through.
	The problem is that the transaction costs—the bureaucratic costs—will actually rise. Before the previous Tory Government introduced the internal market, the money spent on NHS bureaucracy was just 4%, but that has increased to 12%. I am willing to bet any Member on the Government Benches that the level will go well above 12%, because once legal contracts are required, once the lawyers, accountants and God knows who else gets involved and has to be paid, and once we end up with court actions, the transaction costs will rise. That is why these proposals are a disaster.

Andrew George: It is a pleasure to follow the right hon. Member for Holborn and St Pancras (Frank Dobson) and I was glad that his speech contained an element of recognition of the excellent contribution made by my hon. Friend the Member for Southport (John Pugh), who set out far more articulately than I could many of the concerns about the legislation which underpin this evening’s debate. These concerns have been raised by Liberal Democrat Members and I know for a fact that a number of Conservative colleagues feel the same way about aspects of the reform, although that has not been articulated this evening.
	I wish to get one piece of rough and tumble out of the way before I commence with the substantive comments I wish to make in the short time available to me. I will not be supporting Labour’s motion this evening because to do so would be to endorse Labour’s history of having introduced the following: independent treatment centres, which wasted hundreds of millions of pounds of taxpayers’ money; alternative providers of medical services enforced through primary care trusts; and many other top-down reorganisations, which Labour Members now pretend they are against. It would also mean endorsing their approach to the whole concept of top-down reorganisations, the billions that Labour wasted on NHS IT systems and Labour’s failure to address the unfair funding formula, which set back my part of the country significantly and left it in significant debt, from which it is still trying to escape.
	I set out my position in the Second Reading debate on the Health and Social Care Bill, on 31 January, when I refused to support the Government because of the criticisms and concerns that I raised then. I do not need to repeat them now, but I also made it clear then, as I do now, that I would vote against the Government on Third Reading if the Bill were to look in any way like the legislation that we saw come out of the Committee and which will come through to the Report stage. I therefore look forward to the outcome of the listening exercise, and hope that it is a genuine listening exercise and that substantial changes will be made to the Bill. The changes that I wish to see are so substantial that they would take the guts out of the Bill.
	To the concept of commissioning proposed in the Bill and the idea of handing all that power to one narrow group of clinicians—GPs—there is, despite what the hon. Member for Banbury (Tony Baldry) said about GPs in his area, at best a resigned reluctance and at worst outright hostility about what GPs are being asked to do. I do not go along with the hon. Gentleman’s view that they are keen to get on with it. They are responsible people and responsible professionals; they recognise when they are being asked to do something and they will get on with it, but I must say that they will not do so with any enthusiasm.
	Secondly, the substantial elephant in the room is not the risk of privatisation of the NHS, as the hon. Member for Easington (Grahame M. Morris), who is no longer in his place, described it, but the marketisation of the NHS. My hon. Friend the Member for Southport (John Pugh) put it well: the cherries will be picked by the private sector. Any decisions on commissioning could easily be unscrambled by a process whereby decisions that were intended to try to integrate services could be challenged because they were structured uncompetitively. Those are two fundamental failings in the legislation.
	This comes to the heart of what coalitions are about. No one gets their own way, as Labour knows from being in coalition in other places, and it is silly to be childish about that. In a coalition, the parties work together when they agree and seek a compromise where they fail to agree. I would argue that when they cannot come to any kind of agreement or compromise, they should allow Parliament to decide. What I do not like about what is happening is the fact that the Secretary of State is largely implementing this legislation—

Owen Smith: I am delighted to follow the hon. Member for St Ives (Andrew George) and to hear him say that, were this a Third Reading debate and the Bill had remained as it is, he would vote against it. He should not hold his breath, because we have not heard any indication from those on the Treasury Bench that they propose to listen to the reasoned and substantive opposition that we heard in the Public Bill Committee, of which I was a member and where the Government rejected all 250 to 300 suggested amendments, or to that in the rest of the country, where doctors and all the medical professions are united in opposing the Bill.
	Earlier, those of us on the Opposition Benches were admonished for the sound and fury coming from us. Mr Speaker was right to admonish us for shouting, but that sound and fury is not born of cynicism; it comes from three things. The first is our outrage at how the history of what the Labour Government did in office is being rewritten and at the suggestion that this Bill represents an evolution of what we did with the NHS. It is not an evolution, but a revolution.
	The second is the shameless way in which the Government are misrepresenting that which sits at the heart of the Bill. They present it as trying to bring about patient focus and GP-led improvements to the NHS, but in truth it is about competition and the Government’s belief that competition in health care, like in telecoms or the energy market, is the best way to drive improvements in the efficient allocation of resources, allowing consumer-driven demand to drive efficiency. We fundamentally contest that. We do not think that it is true in many aspects of life, but it is certainly not true in the NHS, a body built on collectivism, co-operation and integration. Those fundamental ethics—the ethos of the NHS—will be undermined by the Bill.
	Thirdly, the Bill is a completely unnecessary intervention. We did not need a top-down reorganisation of the NHS, because we got record patient satisfaction and increased productivity in all the ways that matter, as described earlier by my right hon. Friend the Member for Holborn and St Pancras (Frank Dobson). Crucially, we have a far more efficient and better-resourced system than previously. That prompts the question of why the Government are pursuing this change. They are doing so because they fundamentally believe that the way in which to drive the NHS forward is through an unfettered market and greater deregulation.
	That brings me to my substantive point. I want to rebut the notion which we have heard repeatedly from the Government that competition will not bite harder
	on the NHS as a result of the changes. The Government have told us repeatedly that nothing in the Bill says that competition will impact on the NHS to any great extent. As we all know, however, in 100 of the 300 clauses Monitor is established as an Office of Fair Trading-style competition overlord for the NHS, because as soon as the NHS is opened up to multiple entrants in the market and there are multiple providers of health care services in this country, we will no longer be able to argue that it is a state service that ought to be protected and therefore should not be subject to the vagaries of the market and EU competition law. As soon as we allow multiple health providers into the market, we will have to apply EU competition law, and European case law and arguments between lawyers will inevitably lead to the progressive fragmentation of the NHS.
	There is one other point with which I want to take issue. Privatisation is a pretty difficult word to bandy about in politics, but I do not shy away from using it in this debate. We are going to see a progressive and creeping privatisation of the NHS. To argue about marketisation and privatisation is to argue about semantics. We will increasingly see many more aspects of the NHS either in the hands of or being delivered through the private sector. Earlier, the Secretary of State asked us to point out where in the Bill it showed that there would be an increased number of private providers in the NHS. My challenge to the Minister of State, Department of Health, the right hon. Member for Chelmsford (Mr Burns), who is now back in his place, is to point out to me where in the Bill it says that we will not see more private providers entering the marketplace. The Bill provides for that to happen and what will arise from that is the break-up, fragmentation and, eventually, privatisation of the NHS. Those on the Government Front Bench know that—

Daniel Poulter: I agreed with very little of what the hon. Member for Pontypridd (Owen Smith) said when we were on the Public Bill Committee together, and I am afraid that I will not change my view after hearing what he has said today. He touched, however, on the important issue of health economics. In a thoughtful speech, the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) made some good points about health economics. Much as I would rather talk just about patient care, given my medical background, health economics are at the centre of the discussion about how we will reform and improve the NHS.
	The comprehensive spending review announced that the NHS would see its funding rise by 0.4% in real terms over the next four years. Despite the current economic climate, the Government have stood by their commitment to increasing NHS funding over this Parliament—we are very proud of that—but, even so, it is the smallest increase in NHS funding for decades. Ever-increasing patient demand for health care coupled with Britain’s demographic time bomb means that over the next few years the NHS will have to achieve value for money for its patients on an unprecedented scale.
	Our NHS needs to make efficiency savings just to stand still and to continue to deliver high-quality patient care. My right hon. Friend the Member for Charnwood
	(Mr Dorrell) hit the nail right on the head when he said that we need to think about not just the worried well but the 80% to 85% of patients who have serious medical co-morbidities or present as emergencies with acute medical problems in accident and emergency. That desire lies at the heart of the Government’s proposed reforms.
	People are living longer, and as they do, the number of people living with multiple medical co-morbidities also increases. The majority of people require their health care in the later stages of their lives and if we are to have an NHS that is truly responsive to the demographics of this country, we need to ensure better integration of health and social care. We must stop the silo working that often exists between local authorities and the NHS and ensure that we have a more locally responsive NHS. At the heart of the Bill is a desire to see better integration of adult social care and NHS care, which can only be a good thing in view of this country’s demographics and of the health economics of looking after people in the later years of their lives.

Daniel Poulter: If the hon. Gentleman will forgive me I will not give way because time forbids it.
	In conclusion, the NHS needs to be reformed and needs to improve the care it delivers to patients. We can no longer afford to sustain the amount of wasteful spending on management and bureaucracy that occurs in the NHS. We need a less bureaucratic NHS—a clinically-led NHS that can once again put its patients first. The NHS has become obsessed with management and process but if we want to reform it, then it must be the patient who counts.

Jeremy Lefroy: I would like to take this opportunity briefly to raise three matters and I hope that my right hon. Friends on the Front Bench will, in the spirit of the listening exercise, take note of them. I know from previous experience that these issues concern them. They arise in relation to the public inquiry that is going on at the Mid Staffordshire NHS Foundation Trust.
	First, the motion refers to an NHS that refuses to tolerate unsafe care and that achieves quality and outcomes that are among the best. I do not think that any right hon. or hon. Member would disagree with either of those aims. One thing that has come out of the Mid Staffordshire inquiry is the whole problem of unsafe care, particularly the quality of care that elderly patients receive. Mid Staffordshire is by no means the only place for which that has been a problem. It has been highlighted in a recent report as being an issue for other parts of the country as well. For me, the key question is how patient care and safety can be upheld to the highest possible standards across the NHS. Occasionally people have cited the example of civil aviation in this country. Both
	the Civil Aviation Authority, which has a first-class safety record, and the NHS serve the public. The CAA emphasises continuous improvement and risk-based monitoring. I urge my right hon. Friends to look at the example and practices of the CAA and consider how those might be incorporated in the work of the NHS.
	The Health and Social Care Bill contains helpful provisions on patient safety. GP commissioning will bring commissioning closer to patients. It will ensure that if there are problems, they will be heard about more quickly. The health and wellbeing boards will ensure greater local accountability and again, problems should come to the attention of the authorities more quickly, as was not the case in my own trust. Healthwatch will be established and there will be more foundation trusts.
	However, there is a risk of a fragmented approach to patient safety. We have the Care Quality Commission, but as hon. Members who served with me on the Public Bill Committee know, there are concerns about the additional work load that will be placed on the commission. Will it be able to cope with the volume of work? Will it be able to ensure that patient safety and quality of care are upheld across the NHS? I should like to hear the Minister of State’s comments on that. It has been suggested that the critical question of patient safety should be brought to the top of the NHS, perhaps with a directorate within the Department of Health reporting directly to the Secretary of State on patient safety. I should also be interested in his comments on that.
	The second point that I wish to make is about foundation trusts, which were key under the previous Government and will continue to be so, but I am concerned about the level of training available to governors and directors. I should like to hear my right hon. Friend’s comments on that. I refer particularly to foundation trusts that are responsible for district general hospitals, which many hon. Members have in their constituency, as do I. Those are the trusts that will probably come under most pressure in the current constrained financial circumstances, and that would have been the case under any Government.
	My third point relates to the length of contracts that are awarded. Whatever the position is with competition under the Bill on Report, it is clear that contracts, whether with NHS or outside providers, will be of the utmost significance. I am concerned that contracts are sometimes awarded for only a short period. Hence, a considerable amount of time is taken up with tendering and retendering. I ask for some comments on that.
	In conclusion, the Francis inquiry, which we expect to report later this year, will be one of the most significant reports on the national health service in the past 20 or 30 years. I urge the Government to take good note of its conclusions and implement them as far as possible.

Emily Thornberry: The great strength of being in opposition, in many ways, is the opportunity it gives us to listen to interested groups of every type, including representatives of the work force, experts and the public, and to hear their concerns about the Bill. Those concerns translated into more than 300 amendments that we tabled in Committee and more than 100 votes. As I have said, the Government considered it wise not to give an inch. However, on the day after the Committee finished its considerations, the Government decided that there ought to be a pause so that they could think again. The very fact that they decided to think again tends to encourage us to think that we might have been right in the first place. What a shame it was that they did not listen to us earlier.
	For the Health Secretary, it must seem a lifetime since the Prime Minister said about him:
	“He is probably the Health Secretary in the last 20 years who has the greatest understanding and greatest passion for the NHS.”
	His Deputy Prime Minister stated in the foreword to the NHS White Paper that the reforms were
	“rooted in the coalition’s core beliefs”.
	Patient groups, professional bodies and health experts gave the underlying principles of the White Paper a cautious welcome, but I ought to explain to the Secretary of State that there is a difference between giving a cautious welcome to the underlying principles of a White Paper or Bill and reading the Bill and realising that it will not deliver on those underlying core principles. That is why there has been an increasing chorus of opposition. Our difficulty is that, although there were more than 6,000 responses to the White Paper, those concerns were largely ignored. When the Bill was published, those concerns increased to alarm and the criticism became less diplomatic, less polite and more forthright, and yet the Secretary of State continues not to listen. More people began to join the Opposition’s side of the argument. Although at the beginning the Secretary of State might have felt encouraged that he had many people in his “liberate the NHS” team, as more people realised just what the Bill was about, more and more of them decided that they had been on the wrong side of the argument and that the Bill was wrong and so crossed the room.
	I pray in aid the comments made by the hon. Member for Totnes (Dr Wollaston), who talked about throwing a hand grenade into the NHS, and those of the Royal College of Nursing, which passed a vote of no confidence in the Secretary of State, with 98% of the vote. Its general secretary said that the Bill
	“could well turn out to be the biggest disaster in the history of our public services”.
	The British Medical Association called for
	“a halt to the proposed top-down reorganisation of the NHS”.
	When I listened recently to the hon. Member for North Norfolk (Norman Lamb), I was reminded of Luke 15.7 —there shall be more joy in heaven over one sinner who repenteth than over 99 just persons who do not need to repent. The number of people who are moving over to our side of the argument are becoming a flock. They say they realise that the Bill is not what they had first thought it was, that it needs to be fundamentally changed, and that if it is not fundamentally changed it needs to be scrapped.
	Lord Owen has said:
	“The coalition unexpectedly and inexplicably forged ahead with legislation for NHS reforms of staggering ineptitude.”
	Lord Tebbit, who I believe is the Secretary of State’s former boss, has said:
	“What worries me about the reforms, however, is the difficulty of organising fair competition between the state-owned hospitals and those in the private sector.”
	I could go on. Michael Portillo has said of the Tories:
	“They didn’t believe they could win an election if they told you what they were going to do because people are so wedded to the National Health Service.”
	The whole of the Liberal Democrats have also crossed the room. Evan Harris has talked about the Bill being “disastrous”. Although I heard the right hon. Member for Charnwood (Mr Dorrell) say encouragingly that the Bill would give
	“a holistic basis—a structure for the health service, going forward.”,
	the Health Committee’s report has not been so enthusiastic, if indeed what he said today could be characterised as enthusiastic. Lady Williams has said that the Bill is “completely misconceived”, and the right hon. Member for Bermondsey and Old Southwark (Simon Hughes) has said that it needs “fundamental change”.
	The Health Secretary must be feeling increasing lonely. Perhaps the most deadly time was when the Chancellor of the Exchequer stated:
	“I want changes too, and so does David Cameron”.
	I appreciate that the Health Secretary has the Minister of State, the right hon. Member for Chelmsford (Mr Burns) and the Under-Secretary of State, the hon. Member for Guildford (Anne Milton) on his side, along with the hon. Member for Banbury (Tony Baldry). I respectfully suggest to the Health Secretary that he holds very tightly to the hand of the Minister of State, the hon. Member for Sutton and Cheam (Paul Burstow). It must seem a very long time ago that the Prime Minister said:
	“I have been involved in designing these changes way back into opposition with Andrew Lansley. I take absolute responsibility with him for all the changes we are making.”
	We will see just how long it is that the Prime Minister stands shoulder to shoulder with his Secretary of State.
	There has been great excitement in SW1 bubble land on what effects the NHS reforms will have on the coalition and what the Lib Dems will do next, but the fundamental point is that it really does not matter what happens in SW1; what matters is what happens to our national health service. The Bill is a threat to our national health service. Leaving aside the political shenanigans and the saving of the Deputy Prime Minister or the Liberal Democrats’ soul, what is important is what happens to our national health service. We should be looking at the fundamental principles in relation to that. Everything else is just words, words, words. We are told that we must not rush GPs into consortia, but the
	majority of them have already been rushed into consortia and their PCTs are being abolished. If that is the extent of the fundamental reforms that the Liberal Democrats want, that would be very disappointing.
	We in the Opposition have five tests: delete part 3 of the Bill; keep waiting time guarantees; ensure that consortia are not too small, involve wider expertise and require openness and accountability; ban GP bonuses, stop conflicts of interest and do not allow commissioning jobs to be done by the private sector; and keep a cap on the number of private beds. Let us do that, which would be a fundamental change to the Bill. Most importantly, let us delete part 3.
	Instead of wasting time, energy and money on unnecessary top-down reorganisation, the Conservative party should have been building on Labour’s achievements. When we handed over the NHS to the Conservatives, we did so in trust. They should have built on our achievements. I am not saying that the NHS was perfect, but it was much better than it was when it was handed to us. These reckless, costly and ideologically driven reforms are not doing well for the health service. As the hon. Member for Totnes has said, while competition has a role, it is not an end in itself. If we allow competition to run rife within the NHS, it will fundamentally undermine its essence, which is that it is built on a culture of collaboration and co-operation. It is an expression of our fundamental commitment to equality.

Simon Burns: At the instigation of the Opposition, we have spent the past three hours debating the future of the national health service, and yet in not one single speech from their Members did we hear any mention of what they would do for the future of the NHS. We heard from the right hon. Member for Holborn and St Pancras (Frank Dobson), who is always a joy to listen to. He objected to the Blair/Brown health service reforms and to our proposals to improve the NHS, apparently without fully understanding them. We heard speeches from the hon. Members for Pontypridd (Owen Smith) and for Easington (Grahame M. Morris) that were simply a continuation of what we had to listen to for eight long weeks in the Bill Committee.
	We had a sensible and reasonable speech by my right hon. Friend the Member for Charnwood (Mr Dorrell). My hon. Friend the Member for Totnes (Dr Wollaston) made an interesting speech and was right—absolutely right—to encourage the greater integration and seamless provision of social care and health care, because that is so important.
	We had an excellent speech from my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), which was based on his experiences of having worked in the national health service, and we had a good speech by my hon. Friend the Member for Stafford (Jeremy Lefroy), who raised a number of questions. Time does not permit me to answer them all, but I remind him that, because of my right hon. Friend the Secretary of State, the Care Quality Commission started an unannounced investigation of nursing in hospitals to look specifically at dignity, respect and safety.
	During this debate there have been times when the facts seem to have been obscured, so it is time that we had a reality check: our population is ageing—in 20 years’
	time 2.5 million people will be over the age of 85; the cost of new medicines has almost doubled in the past 10 years, from £6.7 billion to £11.9 billion, rising last year alone by £600 million; and new surgical procedures are breathtakingly effective but expensive.
	Those are the pressures facing the NHS at a time of economic turmoil inflicted on this country by the previous Labour Government. As a result, there are real challenges that the NHS must meet, so it does no one any good to scream “privatisation” as soon as we start exploring the best ways to safeguard the health of our children and of our children’s children. It is scaremongering of the lowest order, because this Government will never privatise the NHS. We have been, and we always will be, committed to an NHS free at the point of use for all eligible to use it.
	In fact, when the Labour party was in government, it introduced private companies into the NHS on a scale that would have produced howls of outrage if we had done the same, but it was not privatisation then and it is not privatisation now. The previous Labour Government gave £4.7 billion to private companies in 2009-10 alone, and unbelievably, to add insult to injury, £250 million of that money was given to private providers as payment for operations that never even happened.
	We want to see a much fairer relationship, one that does not undermine the NHS but means increased choice for patients and better outcomes. That means saving thousands of lives every single year from conditions such as heart disease, respiratory disease and cancer. It means people with long-term conditions having their quality of life revolutionised with the seamless provision of care; the care that people receive being as good it possibly can be, based not on percentages or pie charts but on people’s real experiences; and the relationship between patients and doctors being humanised rather than seen as a means to an end—a relationship of equals based on trust, transparency and the best available treatment from the best available provider.
	Every sensible-thinking person in the House knows that patient care can be improved if the NHS becomes more efficient. Efficient treatment is faster, cheaper and more effective. The previous Government knew that as well. We are carrying on their plans for £20 billion of efficiencies, plans that the right hon. Member for Kingston upon Hull West and Hessle (Alan Johnson) brought in, whereby every penny saved will be reinvested in patient care.
	To those who say that the plans are happening too fast, let me remind them that this coalition Government are giving the NHS an extra year to find those efficiencies, over and above what the Opposition would have allowed. On top of that, we are protecting front-line spending and, in fact, increasing the NHS budget overall in real terms.
	We also want to see the quality of our clinical care improve so that a patient’s care will be among the best in the world, whatever they are being treated for. But these are not just pretty words and noble intentions; we are making real changes and patients can already see a real difference.
	We are removing layers of unnecessary management so that clinicians have the freedom to look after in-patients rather than inboxes, and there are examples of improvements in care throughout the country. To look
	at just one, Oxford’s John Radcliffe hospital has invested in an electronic blood transfusion system that cuts the time taken by staff to deliver blood and reduces transfusion errors to improve services for patients. That saves the NHS £1 million every year to reinvest in patient care, because it is more efficient. That is the reality of efficiency, and it goes hand-in-hand with innovative, forward-thinking care.
	Underpinning all our plans is the philosophy that a more integrated NHS is a better NHS—ending stop-start care and making sure that, from the point of diagnosis, every patient has seamless care that spans health care, social care, mental health care and, of course, a reliable support network afterwards so that patients can just concentrate on getting better.
	We want GPs and other health care professionals, social care providers and local councils to come together to provide seamless services, whereby, for the patient, the lines drawn between those organisations fade to nothing. Giving autonomy to clinicians, in the form of consortia, will allow that to happen, and I hope that that reassures my hon. Friend the Member for Totnes.
	Let us ask Dr Howard Stoate, who some Members might remember was Labour MP for Dartford until last May. [ Interruption. ] I know that the hon. Member for Islington South and Finsbury (Emily Thornberry) does not like this, but she will have to listen to it once again, because he is leading pathfinder consortia in Bexley. GPs such as Dr Stoate take a broader, more responsible view of care, working with others throughout the country and across primary, community and secondary care to manage, treat and refer their patients.
	They are all in an ideal position to design services in collaboration with all the different strands of the NHS and, of course, with those beyond the NHS as well. Patients, who will have their own personal care budgets to spend how they like, will be involved every step of the way.
	As I have said before, everyone knows that the NHS has to change. The noble Lord Warner, a Labour Health Minister for more than three years under the previous Government understands that point. [ Interruption. ] I am disappointed that the hon. Member for Leicester West (Liz Kendall) laughs, because at the time she thought that he was a valued Minister in the Department of Health. That point about change is in his book—a thoroughly good book, by the way, which I suggest she reads if she has not already done so. He says that reform is essential, because failure cannot be allowed to carry on taking taxpayers’ money and providing a sub-standard service to the public.
	Reforming an organisation the size of the NHS is a big challenge, but it is also a big opportunity. What we propose is not simply to tread water or to be satisfied with the NHS just scraping by; we want to see it improve for the benefit of patients in every way.
	There is no reason why we have to put up with care that is anything less than world-class, and our plans revolve around that happening: cutting down inefficiency; empowering clinicians; giving them—

Margaret Curran: I thank the Minister for her contribution, and I wish to make a few comments in response. On behalf of Labour I welcome the Government’s motion, and we look forward to the full debate in Committee about the substance of their proposals. However, we are disappointed that we must have that debate in the Welfare Reform Bill Committee, because as she will be aware, a child poverty strategy has been published and there have been a number of criticisms of it. It would perhaps have been better if the commission had been set up first, to inform that strategy. I will return to that point, because that situation perhaps explains why there have been so many comments that the child poverty strategy is insubstantial. I appreciate that the substance of those comments will be featured in Committee, but if I may, I wish to make one or two points about issues that the Committee will cover as it examines the Government’s proposals.
	The child poverty commission was a significant element of the Child Poverty Act 2010, which received cross-party support and was regarded as a landmark piece of legislation. It was to be a commission of status and influence, which would be evidence-led, examine different approaches, engage with those with direct experience, harness the experts’ views and, as the Minister indicated, work with the devolved Administrations. I hope that when the Committee has discussed the matter, she will ensure that the commission does exactly that.
	I am sure the Minister is aware of the substantial point that some child poverty organisations have made in questioning the legality of the Government’s approach to date, given the status of the 2010 Act. They say that because the child poverty strategy has been produced before the setting-up of the commission, the Government are acting illegally. I hope she will address that point.
	The broadest point that needs to be made is about the Government’s decision to widen the scope of the commission from purely being about child poverty to also embracing social mobility. I appreciate the substance of the argument about social mobility, policy on which underpins any Government action. Of course there are links between child poverty and social mobility, and as I understand it, the commission would already have had powers to examine those links. However, the Minister will appreciate that broadening the scope of the commission
	so far has raised many concerns among organisations, and indeed among many Labour Members. There are links between child poverty and social mobility, but they are not the same thing. There is deep concern that including social mobility means that the commission will lose its edge and its focus on dealing with child poverty. It may well dilute the urge to tackle child poverty.
	I have a number of questions to put to the Minister. Given that the matter is now going to the Welfare Reform Bill Committee, may I ask that the commission be established urgently and that there be no further delay? Once its scope has been established, it should go ahead. Will the Minister consult the devolved Administrations on their wider child poverty strategies as a matter of urgency? May we have a guarantee that commitments on child poverty will not be delayed or watered down because of the extension of the commission’s scope to social mobility?
	May we have clarity on what the Government’s child poverty targets actually are? The Minister will know that the Prime Minister made a categorical and unequivocal commitment to maintaining relative poverty income measurements. Can she guarantee that that will still be central to the Government’s proposals? Finally, can she guarantee that the commission will retrospectively examine the already published child poverty strategy so that its fundamental weaknesses can be addressed and we can have an altogether more substantial plan? I appreciate that the meat of the subject will be discussed in Committee, but given that we are making a decision this afternoon on whether to enable the Committee to establish the commission, it would be very helpful if she could address those points.

Kate Green: I very much look forward to a full debate on the merits of the Government’s proposal in the remaining stages of the Welfare Reform Bill if the instruction is agreed to. However, I cannot wholly share the Minister’s reasoning on why it is appropriate to approach the expansion of the child poverty commission’s remit in this way.
	The Minister said that allocating an advisory role to an arm’s length body would in some way weaken the Government’s accountability. I am confused about why advising should mean becoming responsible, and no doubt she will want to explain that. However, I welcome her acknowledgment of the importance of wide consultation. I hope that that will continue to be the case on the subject of the expanded remit that we are discussing.
	I believe the Minister is mistaken to think that the planned child poverty commission would have had as limited a remit as she seemed to imply. As she acknowledged, the 2010 Act and the functions and remit of the commission had cross-party support, and the Act uses a wide understanding of what child poverty encompasses. That includes a number of the building blocks of social mobility, including on parenting, housing and education, that she seems to suggest would be missed. I hope that she can assure us that when the debate is passed on to the Welfare Reform Bill Committee, with its much narrower remit of considering employment and social security reforms, the vital focus on child well-being in its broadest sense will not be lost. That is what child poverty measures are fundamentally intended to address and improve.
	I agree with the Minister that two central thrusts of the Government’s welfare reform agenda lie at the heart of our ambitions on social mobility. She is right that parental employment is crucial to how we tackle and address child poverty. Unless parents can access employment that genuinely lifts them and their children out of poverty, the child poverty targets cannot be met. She is right, too, to say that the Welfare Reform Bill is an appropriate vehicle for the discussion of child poverty. It is clear that neither child poverty nor social mobility can be addressed unless the right financial support is put in place for families with children. That includes the social security support that the Bill targets directly.
	The reason why I mention those two points is that there is considerable international evidence that parental earnings have as much impact on social mobility as other factors such as educational opportunity, and that the most socially mobile and equal countries are those with generous, albeit short-term, social security benefits. That is in striking contrast to the position that tends to pertain in this country and the United States, which is very ungenerous social security benefits that people rely on, in many cases, for quite a long time. It is therefore right that we should debate those issues in the context of the Welfare Reform Bill. In that sense, the Minister’s proposition absolutely stands up. However, this debate also gives us the opportunity to highlight the contradictions and inconsistencies in the Government’s agenda.
	The meat of the Welfare Reform Bill includes issues such as the benefits cap, which will seriously damage families’ well-being, and the reduction in support for child care—we are still waiting in the Welfare Reform Bill Committee to see exactly what the Government will propose, although I think that the Opposition will have concerns about it—as well as access to the labour market for second earners or potential earners in couples and the disincentives that seem to be emerging in the design of the universal credit. They are all issues crucial to child poverty and social mobility, and it is right that they should lie at the heart of the Bill.
	In conclusion, it is right to debate those issues in the context of the Welfare Reform Bill, albeit not just in that context. Doing so gives us an opportunity to remind ourselves that we tackle poverty, inequality and social fluidity not by individualising and pathologising problems, but through the structural solutions that only Governments can provide. Those solutions include ensuring access to education and training, ensuring that parents can access good quality child care, ensuring income adequacy, ensuring the redistribution of income and wealth to reduce the inequality gap, and ensuring the conditions for sustainable, good quality employment that genuinely enables parents to lift their families out of poverty.
	The Government need to be aware that they have at least the beginnings of a credibility problem with those outside this House who are watching and monitoring closely their commitment to genuinely improving the well-being of children and lifting them out of poverty, as the coalition parties, in common with all other parties, last year signed up to do. I very much hope that what we are seeing this evening is not a proposition to marginalise or downplay hard-won gains in securing understanding of the inter-connectedness of poverty, inequality and social fluidity, and, at their heart, the importance of family incomes.

Jennifer Willott: There are issues with child poverty in Wales. The hon. Gentleman and I represent Welsh constituencies. Child poverty levels in Wales are, I believe, higher than in other parts of the UK, just as incomes are much lower. If we are going to tackle the issue in Wales, just as in England and in Scotland, we need to look not just at welfare packages, but more broadly, at the opportunities available to children and young people, as well as their parents, so that they get the best opportunities. I hope that the Minister will say what she is doing with the Welsh Assembly Government and the Scottish Parliament. We need a lot of co-ordination with the devolved Administrations, because many issues affecting social mobility are devolved matters such as education. If we are to take the issue seriously, we need to ensure good communication and liaison between the devolved Administrations and Departments in Whitehall.
	I look forward to debating the issue further in Committee, but I would be grateful if the Minister could respond to a couple of issues this evening. First, can she let us know more about why she feels that combining the expansion of the commission with the proposed change in its remit will increase accountability or ensure that the Government achieve their objectives? For many years Governments have talked the talk, but they have not necessarily walked the walk. I would like the Minister to say more about why she thinks the change will make a difference by delivering good progress on tackling child poverty. I would also be grateful if she could give
	more detail about the timing of the child poverty and social mobility strategies, how they will interact with the establishment of the new commission and how the process will work.
	I welcome today’s proposal and look forward to debating it in Committee in the coming weeks, in what I am sure will be significantly more depth.

Frank Field: Let me add two brief comments to our debate today. The first is directed towards the Liberal Democrats, as I read in the papers that social mobility is an issue that the Deputy Prime Minister is going to take under his wing. Because I feel in a good mood, may I offer them some advice? We in this House might know what social mobility means, but if my constituents are anything to go by, nobody out there knows what the hell the Government or the Liberal Democrats are going on about when they talk about social mobility. My constituents all understand the phrase “life chances” and whether the Government have a strategy in place to ensure that every child in this country has a chance to get a better job than their parents, but if we continue to talk about social mobility, they turn the volume down or switch off. Although I do not mind facing the electorate in such circumstances, the policy is too important to allow the Government or the Liberal Democrats to continue to go over the top, shouting language that neither supporters nor enemies can understand.

John McDonnell: I welcome the proposed instruction to the Committee, on the same basis that my right hon. Friend the Member for Birkenhead (Mr Field) welcomes it. A wider debate on life chances will assist in the tackling of child poverty. I also agree with him on early years provision, although frankly, we disagree on the method of funding.
	I support the concept of commissions, which was begun by previous Governments. The last one in particular sought to establish a number of standing commissions, and I am glad this Government are doing likewise. I welcome the idea of a standing commission of experts who are free to comment at will—critically at times, but on the basis of objective analysis. That helps the Government, whichever party is in power.
	In its representations, Save the Children raised three anxieties on the commission, and I would welcome a Government response to them—I am sure they will respond positively. First, Save the Children says that it is concerned that the commission could have its powers watered down, particularly in relation to commissioning research and consulting relevant experts and groups. It would be worth while to reassure Save the Children that that will not occur.
	Secondly, Save the Children says that the commission has an important role to play in maintaining the profile of child poverty as an issue. Therefore, it is essential that the commission’s ability to advise and inform the public debate on child poverty remains within its broader remit. Once again, it would be worth while for Ministers to give that assurance to Save the Children. Will there
	be full publication and openness and transparency? Will the commission have the ability to publish independently, without Government interference?
	Thirdly, on life chances and social mobility, Save the Children would like us to examine and explore the Government’s thinking on the expertise they will seek to bring on to the commission. Once again, the Government could reassure the poverty lobby on that. If the proposals are amended in that way, the commission will undertake a worthwhile exercise, be open and transparent, and contribute to and heighten the profile of the wider debate on child poverty.
	I agree with my hon. Friend the Member for Stretford and Urmston (Kate Green) about the Government’s solutions to the problem, because some Government policies are driving more children into poverty, but at least we can agree that we need a commission that will provide research and independent advice so that we can have an informed debate. On that basis, I welcome the instruction.

Damian Green: The right hon. Gentleman might well be right. However, it would be unhelpful for me to comment generally on the developments in the Schengen area that, as he and the House will know, might be introduced as a result of events in north Africa. Certainly, however, I agree with the general proposition that each EU member state has to consider its own border arrangements and internal policing arrangements to make it easier for all of us to work together on an international basis in combating what is by definition
	an international crime. That means that to deal with this problem we have to work closely with our international partners, and applying to opt in to the directive is a positive step that Britain can take towards this goal.
	As the House will be aware, we chose not to opt in to the directive when it was initially put on the table last summer, because the draft text had to go through an extensive period of negotiation between the European Council and the European Parliament. We wanted to be absolutely sure that the text would not change during those negotiations in a way that would be detrimental to the integrity of the UK’s criminal justice system. We wanted to consider a final text that had no risks attached and which would not fundamentally change the UK’s already strong position in the fight against human trafficking.

Damian Green: No, I do not, because once the text was available, we looked at it and made the recommendation very quickly, so there has been no practical delay at all. We have examined in great detail the final text and its impacts on the UK, and have concluded that applying to opt in would benefit the UK as well as—most importantly—the victims of trafficking. Applying to opt in to the directive will maintain our position and will continue to send a signal to traffickers that the UK is very serious about tackling trafficking.
	I am absolutely clear, however, that merely applying to opt in is not enough. We have much work to do to ensure that the directive is implemented in an effective way across the UK. There has been great interest in how we will implement certain measures in it, which I will deal with in a moment. The UK already complies with the majority of its measures. We have said from the outset that opting in to the directive will require us to make some legislative changes to ensure full compliance, and we are ready to do that. This will include widening extra-territorial jurisdiction. The directive requires us to establish extra-territorial jurisdiction when the offender is a UK national. It also gives us discretion about whether to establish jurisdiction over cases in which the offender is an habitual resident.
	I know that that particular issue has caused much debate; another is that of child guardians. On this, the directive contains a number of important provisions about assistance and support for child victims of trafficking. We are confident that the UK is compliant with those measures. Local authorities have a statutory duty to ensure that they safeguard and promote the welfare of all children, regardless of their immigration status or nationality. We believe that this responsibility should remain with the local authorities that co-ordinate the arrangements for each child to ensure that they are safe and to promote their welfare.

Damian Green: That is exactly my view, and having another guardian would be confusing and potentially bureaucratic. Indeed, in discussions with the very energetic all-party group on human trafficking, one of its leading officers, the noble Baroness Butler-Sloss made the point that when the directive talks about a guardian, it does not, in her view, mean a guardian ad litem—a legal representative of the child—who would deal with the courts, as happens in “normal” child protection issues. The truth is that the concept of the guardian in the directive is slightly vague, and slightly declaratory, and we believe that our present system is already achieving what the directive wants us to achieve.
	Another provision that has generated great interest is the idea of a national rapporteur on human trafficking. Again, we believe that we have equivalent mechanisms in place that fulfil that purpose, in the form of the UK Human Trafficking Centre, for data collection, and the inter-departmental ministerial group, for oversight. I recognise the concerns expressed by hon. Members and others that this function should be carried out by an independent body, and I will keep those arguments under consideration.

Mark Tami: Is my hon. Friend concerned as I am about the level of cuts to the police forces, particularly in areas such as port security, where traffickers probe for a weak point when they are bringing people into the country?

Fiona Mactaggart: That is what the contract requires of the new organisation. I did not make any criticism of it because I wish it well. It has the job now, although I am sad that POPPY’s talent is potentially going to be lost as it had powerful experience to bring to bear on the problem. I asked for a specific assurance that the new organisation will be allowed to challenge—and provided with the finance, perhaps retrospectively—in cases where its advisers and support staff believe that a decision by the NRM has been inaccurate. I put that question to the Minister and I am sure he will come back to it in his reply.
	I accept that we need value-for-money services. Personally, I thought POPPY provided pretty good value for money for the women victims whom it supported and I hope that the new arrangements will provide a similar quality of support for women, which is gender sensitive and so forth. I know that part of the ambition was to extend it beyond trafficked women to male victims of trafficking—an initiative that I welcome—but I hope we will continue to have the gender sensitivity that is required in the directive and that POPPY so exemplarily displayed.

Fiona Mactaggart: As the Minister knows—because we have discussed the matter before—POPPY did bid for the provision and his system did not approve the bid. It is quite possible that the requirements that the Salvation Army will lay on the organisation to which it subcontracts will not be appropriate for POPPY. As the Minister knows, POPPY had to bite its tongue a bit to make the bid in the first place, and I encouraged it to do so. We cannot be certain that it will be able to continue—or afford to continue—to provide a service of this kind.
	The Minister for Immigration referred to the rapporteur requirement in article 19. I welcome his recognition that—notwithstanding the memorandum that he supplied to the Committee, according to which this was provided by the United Kingdom Human Trafficking Centre and the inter-ministerial group on human trafficking—there is a question to be asked about whether some more independent mechanism might be appropriate. I strongly urge him to adopt that route, and I am glad that he has left the door open.
	I believe that the inter-ministerial group has met once since the election of the present Government. I do not think that that suggests a great degree of oversight. It also worries me that UKHTC does not provide public reports of its work or accessible statistics. In contrast, the Child Exploitation and Online Protection Centre, which is part of the same mechanism, provides detailed figures and reports which enable it to hold the body to account. I think that we need a body which will report to this Parliament, and which will provide it with the necessary figures and details.
	I talked recently to representatives of ECPAT, an exemplary organisation that supports child victims of trafficking. They said that the most recent figures they could get out of UKHTC did not break down the details of victims of trafficking—even children—according to nationality and age, which would have enabled them properly to understand how that ghastly phenomenon operates. I urge the Minister to establish a mechanism which can report to Parliament, and which recognises that the job of a rapporteur is not to administer but to
	find information and report it. At present, the bodies to which he refers in his memorandum do not go in for much reporting.
	Finally, let me deal with the issue of child victims. Shortly before the debate, a number of members of the all-party parliamentary group on human trafficking heard an excellent presentation by Barnardo’s about its work with children who have been sexually exploited. Some have been trafficked, and some are victims of a sexual exploitation of a kind that has parallels with child trafficking. Barnardo’s estimates that there are 1,000 sexually exploited children in Britain today, and that the experience of those children, when they come into contact with the criminal justice system, is of being criminalised rather than treated as victims. I believe that Members on both sides of the House feel shame about that.
	There is an urgent need for us to provide proper protection mechanisms for child victims of trafficking, and that will require, among other things, a proper guardianship system. We know that although, in theory, local authorities take responsibility for the welfare of children, that is not always the case in practice. The Minister mentioned some good practice in Hertfordshire, which we welcome, but, as he is aware, that is the exception rather than the rule. We know that trafficked children disappear from local authority care every week, and that, rather than being found a few weeks later, they are never found. It is horrific that those most vulnerable, most exploited children are not being protected. It is not just a question of protecting them against an uncle, or whoever is trying to instruct a lawyer on their behalf when it comes to criminal proceedings; it is also a question of protecting them against continuing re-trafficking, which, as is fairly clear, is unfortunately what is happening to many children in Britain today.
	Signing the directive would give Britain an opportunity to make a real difference, but we need a practical strategy to implement its proposals. We were promised that in the spring, and the Minister referred to it again tonight, but progress seems to be at best confused, and at worst even more confused. It is slow and a bit muddled. I have been told by voluntary organisations that have been consulted about what the strategy might include that different Home Office civil servants have been put in charge of it, that meetings keep being arranged and then cancelled, that people are not given papers before meetings, and that the timing of a meeting that was due to happen the following day is changed and no agenda is circulated.
	I believe that the increasing number of voluntary organisations that deal with human trafficking—including the excellent Human Trafficking Foundation, which was created by a former Member of Parliament for Totnes—are beginning to feel that the Government are trying to use them as a free research resource without listening to their concerns. We want the strategy, and we want it to be as specific as the last strategy—which, I note, has disappeared from the Home Office website, and which had the benefit of specific targets.
	I hope that the Minister for Immigration will be able to reassure us that there will be proper consultation about the strategy, that voluntary civil society organisations will be involved as is required by the directive, that they will be properly involved and not asked to attend meetings without an agenda, and that the strategy will be not
	merely a high-level document with no specific facts and figures enabling people to be held to account, but a concrete set of promises. It is time that we had such a strategy. it was promised for the spring, and my gardening practice tells me that the spring is very nearly over.
	Let me end by welcoming today’s decision, which I am sure the whole House will support, and by urging the Minister to do more to make the provision work well in practice. He has some of the necessary ideas, but we need to ensure that they are implemented.

Tom Brake: I am very pleased that we are having this debate. The fact that we are doing so is a tribute to Members on both sides of the House and others, including the Minister for Immigration, the Home Secretary, the members of the all-party group on human trafficking, Anthony Steen and the hon. Member for Slough (Fiona Mactaggart). It is a collective achievement, therefore.
	As Members will know, in Europe alone the estimated value of trafficking is £3 billion, and about 140,000 people are being held in conditions of effective slavery in Europe. This morning, I had a meeting with Croydon Community Against Trafficking, which has done very good work in identifying brothels. From its research, it concluded that there were 65 brothels in Croydon. It passed that information to the police in Croydon, who had identified only eight brothels. This shows the scale of the problem we are facing both in European terms and at the local level, and it highlights that human trafficking, especially for the sex industry, is a significant issue.
	I want to thank the Home Secretary again. We have had an extensive exchange of correspondence on this matter over the past three months or so, and there are a couple of points on which I seek clarification relating to the impact the EU human trafficking directive will have in the UK and any additional measures the Government might intend to take. When I intervened on the Minister on the topic of guardians, he said he was confident that the combination of an independent reviewing officer and an advocate was, in effect, a guardian or the equivalent thereof. I am sure he is right, and I hope so too because when we have to respond to the petition on guardians with 600,000 signatures that ECPAT is apparently going to be handing in on Thursday 12 May, it will be much easier if all Members can collectively say that the matter has been addressed. It will save us a significant amount of pain if we are in a position to say that.
	It is my understanding that forced begging is already a crime in the UK. I ask the Minister to clarify either now or later whether a comparable legal penalty is attached to that, and whether as a result of the implementation of the human trafficking directive we will follow other countries in recording the figures for forced begging so that we can draw straight comparisons. In my mind at least, there was also some confusion as to whether other offences that are not currently covered in the UK are addressed by the directive and therefore whether we might now have other offences as well as forced begging.
	Victims of trafficking receive free medical care, but what support in respect of accommodation, and especially safe accommodation, is there, and does the Minister expect that to be provided to all victims? On the protection
	of victims in criminal proceedings, the Home Secretary confirmed that special measures such as witness protection and anonymity are not guaranteed, but are granted on a case-by-case basis. I hope the Minister can give some reassurance that they will be available in cases where that is clearly necessary. Also, there is a suggestion in the response that if legal aid is not available, victims should seek help from non-legal professionals or legal voluntary organisations such as citizens advice bureaux. Given the nature of these crimes, will the Minister consider whether victims should, in fact, receive proper legal support when they require it?
	I referred in my opening comments to Croydon Community Against Trafficking, and I congratulate that voluntary organisation on the work it is doing. Following promptings from Anthony Steen, it is trying to expand its network to all the London boroughs. Many of its activities are based on following leads from adverts as they appear in newspapers. I am sure that Members will welcome the fact that Newsquest—which produces many of the local newspapers around the country, including my own, the Sutton Guardian—has given a guarantee that it will not carry these ads. That is not the case for others, however, such as the Advertiser group. I am afraid that on occasion its papers are in the bizarre situation of featuring on the front page articles about raids on brothels that have resulted in their being shut down, while on the back pages carrying adverts for the services of those brothels. I hope the Minister will address that. He has welcomed the actions of Newsquest, and I wonder whether he might like to put a challenge to other newspaper groups in respect of the adverts they continue to carry.
	I also ask the Minister to set out how he sees the time scales developing from now on, in respect of any other measures that might be taken or hoops that might have to be jumped through, before we can finally say that the EU human trafficking directive has been adopted in its entirety and we can once again commend all the actions that have collectively been taken to ensure this becomes part of the UK’s legislation.

Keith Vaz: As always, it is a pleasure to follow the hon. Member for Carshalton and Wallington (Tom Brake) in a debate on human trafficking. He served with distinction on the Select Committee on Home Affairs a few months ago when we published our report into human trafficking. That took over a year to complete, not because we were not seeking to inform the House more quickly, but because the more we investigated this very important subject, the more information came before us and the more we wanted to get to the bottom of the root causes of human trafficking.
	This is a unique debate because Members on both sides of the House are lavishing praise on the decision of the Minister and the Government. That is an unusual situation for the Minister for Immigration, which he should appreciate and put in the bank for future occasions. He and the Government have done absolutely the right thing in opting into this directive. It will make a huge difference in respect of our uncovering the sources of human trafficking and dealing with those criminals who make such a vast amount of money—£32 billion worldwide, which makes trafficking the second largest
	illegal industry after drugs. If as a result of what the Government are doing today we catch more of these criminals, signing in will be worth it.
	It is right that we pay tribute to Anthony Steen for the work he has done for many years. Even though he is no longer a Member of the House, his spirit lives on in the all-party group and I am sure he is watching the deliberations of the House today and that tomorrow I and other Members will be getting an e-mail pointing out all the things we should have said on this matter and all the things he feels we can help him with in the future.
	I pay tribute to the hon. Member for Wellingborough (Mr Bone), who took over as chairman of the all-party group and has done a fantastic job in ensuring this issue remains at the forefront of Parliament. Given his views on Europe, he is going to make a piece of incredible parliamentary history today in supporting an opt-in to something that has been proposed by the European Union. We should not forget this important piece of parliamentary history. We will hear from others involved in tackling trafficking, and may I say what a good thing it is that the House is relatively full for this time of night?
	As has been said, this is of course an issue for this country, but we need primarily to go to the sources of human trafficking to try to find out why and how people are trafficked. As part of that, we need to examine the developments in the European Union, and I raised that issue when the Minister spoke just now. The recent developments on the Schengen arrangements will help us to try to catch some of these criminals. This country is, rightly, not part of those arrangements, so we are observers and we have no direct interest in those matters. We are not the decision makers—this will be done without the United Kingdom’s involvement—but of course we are the beneficiaries of any changes to the Schengen arrangements that mean that the borders of Schengen countries are protected and measures are in place to ensure that those who seek to use the freedom of movement in the European Union for criminal purposes, be it illegal immigration or human trafficking, are checked very carefully. I hope that, although we are only observers, the Minister and the Government will make relevant comments to our colleagues in the European Union about how these measures will affect not only illegal immigration, but, more particularly, because of the nature of this debate, the way in which we deal with those involved in human trafficking. These measures are not an end but a beginning and this Government, Members of this House and others have a constant desire to make sure that we are vigilant against those who are trafficking people.

Peter Bone: It is a great pleasure to follow the right hon. Member for Leicester East (Keith Vaz) and, as usual, I agreed with every word he said. I very much appreciate his kind words about me and, in return, I shall say that the work of the Home Affairs Committee under his chairmanship is most welcomed in this field.
	It would be wrong of me to start without mentioning the two excellent Ministers on the Treasury Bench, the Under-Secretary of State for Justice, my hon. Friend the Member for Reigate (Mr Blunt), and my hon. Friend the Minister for Immigration, who have played an important role in bringing us to where we are tonight. They have both had the time and the patience to talk to the all-party group on human trafficking and we appreciate that.
	I welcome the directive and I should also congratulate the previous Government, because, on a non-party political basis, we are building on their work. They took us into the Council of Europe convention on action against trafficking in human beings, which is now being embodied in EU law. The all-party group, under Anthony Steen, did much in the previous Parliament to push that Government in that direction and it is the role of our group to continue to push this Government. Although we welcome the debate and will lavish praise on the Government tonight, we will return to particular points and push the Government hard. My great concern about the EU directive, which I have expressed on many occasions, is that it must be seen as the minimum, not the maximum. We must go much further than it does.
	For me, the great thing about opting into the directive is that it sends a message to EU countries that in this country we are serious about the problem, which will encourage other EU countries to do more. We cannot stop human trafficking on our own; we must work with our European neighbours to stop it. To that end, I am pleased with the all-party group’s initiative to try to set up similar all-party groups in other parts of the EU. We have obtained a grant from the EU to do that.
	I praise both Ministers for the decision on victim support. The Under-Secretary has not blown his own trumpet enough tonight, as, at a time when there are
	cuts, it is quite amazing that the Government have managed to increase the funding for victim support. Personally—this is my view, not necessarily that of the all-party group—I think it was right to award the contract for looking after adult victims to the Salvation Army. I have seen the proposal and how it will spread a network of safe homes across the country, involving many different organisations. In a way, it is a big society solution to the problem. Although the POPPY project did an excellent job, it was very London-based. More victims will be looked after better by the new solution and I congratulate the Ministry of Justice on that.
	There is one great scandal on which we will continue to press the Government. Adult victims of human trafficking are looked after in this country, previously through the POPPY project and now through the Salvation Army, and they are put into safe homes and helped back into normal life. They can either go home to their country of origin or settle properly into this country and they are given help in bringing prosecutions against the dreadful people who do the human trafficking. It must be far worse for a child victim of human trafficking than for an adult. A young child, aged 15 or so, might be brought into this country having been told that they will have a job in a store, but might suddenly find that they are in a brothel and repeatedly forced to have sex. That must be far worse for a child than for an adult.
	What happens to those child victims? As a child, the local authority has to look after them, but there is no particular provision for local authorities to look after trafficked children. They do not even identify them—the provision is a bolt-on to the local authority system. All that happens is that these children are taken into care and then re-trafficked. That scandal must be sorted out. I am pleased that the Government have just awarded a grant to Barnardo’s to set up a safe-home system for children. Admittedly, there will be only 16 children to start with, but that has to be the way forward. We must treat trafficked children differently from ordinary children who come into local authority care. The all-party group will be pressing the Government on that issue over the next few months.
	I also welcome the Government’s four-pronged approach to trafficking and to setting the new goals. I also welcome the fact that they are taking time to reach a decision, as I would prefer them to take as long as possible and to get it right. I do not really care whether in Government terms the spring finishes at the end of July, so long as we get it right. There was much criticism of the Government before, saying that they would not opt into the EU directive, but they have done so. Now, there is a lot of chatter that the Government will make a mess of the strategy on human trafficking, but I do not believe that. I hope that when it comes before us we can have another debate and can push the Government further. We are clearly moving in the right direction.
	There are two issues about the directive that I want to mention which I think the Government are going to have to consider seriously over the next few months. The first concerns the rapporteur—I have only just learned how to say that word because it is foreign. It seems to me that the Dutch model is better than any of the others. It has a rapporteur and a secretary and they account for the whole cost of the system, so it is a minimal amount of money. The rapporteur reports
	independently to Parliament once a year on how trafficking is going in the Netherlands and how the Government’s policies work—that is her entire role. It would be really good if we could replicate that system in this country. Of course, I think that our first rapporteur should be Anthony Steen, who was in the Palace of Westminster earlier talking about this very debate, but whomever we might consider for the role, we should look into doing that.
	The second issue, which is perhaps more difficult, is the requirement under the directive to have guardianship. I shall be at 10 Downing street on Thursday, helping to deliver a petition about guardianship that I believe has more than 600,000 names as a result of a campaign by the Body Shop and ECPAT—End Child Prostitution, Child Pornography and Trafficking of Children for Sexual Purposes. This is a difficult issue—I do not want to pretend that it is not—but we have to get to grips with it and I hope that we in the all-party group can work with the Government to find a solution.
	The Government have done an excellent job on this and I respect the effort and time that the Ministers have put in, as well as the constructive criticism that has come from the Opposition. This is a night to celebrate, but I shall come back in future weeks to criticise.

Michael Connarty: It is a great pleasure to be here this evening to welcome the Government’s proposals. I know that we are going through the European scrutiny process and that we have a right to our debate, but there might be a small tinge or last flourish of Euroscepticism in the forcing of a debate after the date on which the Government had hoped to sign up to the directive. I have seen the letter to the Chairman of the European Scrutiny Committee, so I know that the Government have respected the scrutiny process and the Committee’s wish to have a debate on these issues. That is to be commended for scrutiny purposes and I do not think it will take anything from the eventual signing up to the directive.
	I once asked the Prime Minister about his moral compass in relation to this issue, and it seems that our collective moral compass has come through the magnetic storm of Euroscepticism and out the other side pointing in the right direction. I welcome that greatly. I do not think that the probing questions asked by those who perhaps did not want us to do things on the basis of an EU directive, but wanted us to set up 27 arrangements with other countries, were unhelpful because they made the Government think hard about what was in the directive. Some of the issues that I pressed hard on, such as extraterritorial jurisdiction, are very important and I hope that the Government might join the European Parliament in getting the same clause on extraterritorial jurisdiction into the directive on sexual exploitation and the abuse of children, as that is currently being resisted.
	We have done this just in time. The ECPAT and Body Shop petition has been running for some months and when I looked after it had been closed on 5 May it had 887,575 signatures calling for guardianships to be set up as part of our response to the trafficking of children. I believe that the petition will be presented on Thursday at 10 Downing street on behalf of those organisations. ECPAT has also been supported by the Body Shop financially in its work.
	A month ago, the Commissioner for Children and Young People in Scotland reported on his research into the trafficking of children. From the evidence he had collected, he said there were at least 80 cases he could verify and possibly 200 of which he had had notice. For a small country such as Scotland, that is a lot. If the figure were extrapolated for the UK, the number would be massive—much higher than the figure of 1,000 mentioned by my hon. Friend the Member for Slough (Fiona Mactaggart), and that is just for children. It worries me that there is a massive amount of trafficking going on—perhaps for the purposes mentioned by my right hon. Friend the Member for Leicester East (Keith Vaz), who talked about what he had seen in Romania. Clearly, there is a lot of trafficking going on that we have yet to find out about—much more than some estimates. Some of it might be just to reunite families; some of it might be for benefit fraud; some of it might be for exploitation through cheap labour or begging, as I have seen in other European countries; and some of it might be for other, more nasty, reasons, including sexual exploitation and abuse.
	We have a long way to go. According to the reports I have seen, there were only eight successful prosecutions for people trafficking in England last year. What seems to happen, according to the data that I have, is that the accused plead guilty to a lesser charge. There is not supposed to be plea bargaining in this country, but we know that it happens. The number of proper cases and final prosecutions is very low. There was one well publicised case of a woman police officer who pressed for research into human trafficking, because she had seen it going on, and was told by her senior officer, “We’re not interested in human trafficking. In this force we’re interested in burglaries.” In a case reported today by Barnardo’s, a judge commented to a 14-year-old who had been trafficked and used in a sex ring that it was just a lifestyle choice that she had made. That is frightening in this day and age.
	We have much to do about the scale of the problem. I sent the Minister a number of parliamentary questions. I was told that the trafficking toolkit from 2003 was available to all law enforcement agencies. That was the answer to my question about how many people had been trained by the police forces in this country to handle human trafficking. It was confirmed today by the people from Barnardo’s that only a quarter of police forces have proper child protection units running, so we have a long, long way to go.
	I have received information from contacts throughout the EU. The Human Trafficking Foundation run by Anthony Steen is keen that we should reach out and form organisations such as the one run by the hon. Member for Wellingborough (Mr Bone) in all the countries of Europe. For example, when I went to Hungary, I met representatives of three organisations who could give me lists of 400 women trafficked and re-trafficked—turned over, new women brought into Switzerland by one organisation, and children trafficked from Kosovo to Albania and elsewhere in that part of the world for begging, theft and possibly sexual abuse. It is important that we get round Europe, make contacts, recognise the scale of the problem and see it as a European problem and one that is much wider than the EU.
	We need a new approach to victims, as was said from the Front Bench and supported by the hon. Member for Wellingborough. We should realise that, if we can separate
	the victims from the traffickers, we can deal with the traffickers better, but when they are mixed up and it is suggested that those involved in prostitution rings are somehow accepting of it, we blur the images and people start to think that those in the brothels are the trouble and the problem. It is a massive money-making operation exploiting women as they have been exploited for generations, but now that is transnational and we must do something about it.
	We should take a new approach to the many active organisations. I do not know how the Salvation Army bid will work and who it will work with, but following the debates that we have had here on slavery and trafficking, I have been contacted by organisations that work with Moldova, for example, as my right hon. Friend the Member for Leicester East (Keith Vaz) mentioned. One organisation in London works with an organisation in Moldova trying to stop the young girls coming out of care homes being picked up immediately and offered work which ends up as prostitution in other European countries. We must break the cycle in the country of origin, as was said from the Government Back Benches. There are many organisations actively working in this field which we must pull together and see as a great force.
	Barnardo’s commented that sometimes the authorities think that people who act as guardians—that was not the term used, but the role is similar—looking after the women and children coming out of those rings are treated as though they are amateurs, because they are not professionally paid and they are not formal social workers. In fact, they are more highly skilled and have done more sensitivity training and skill training than many receive in their wide curriculum as social workers. We must start treating such volunteers as part of the force that we can turn to the advantage of those children.
	I will finish by making one further point, as the Under-Secretary of State for Justice, the hon. Member for Reigate (Mr Blunt) is present. We have had a debate on the EU directive on combating the sexual abuse of children. I hope that our Government, who do not have a statute of limitations on sexual abuse crimes, will persuade the EU that in its directive there should be no statute of limitations on those crimes. The current bid from the European Parliament is for a 15-year statute of limitations, which would expand provision in many countries. We need that to be taken out, so that when we catch a person involved in such crimes, at any time, they will be prosecuted and jailed.
	I have been made a UK representative of the Council of Europe’s ONE in FIVE campaign, which is intended to promote the Council of Europe convention on the protection of children against sexual exploitation and sexual abuse, which the UK has signed up to but not yet ratified. I think that we should ratify that convention. I hope that Members who are listening to the debate do not see this problem just as something that happens on their streets and that they have to worry about only in the context of their constituencies. Every time Anthony Steen went abroad with the European Scrutiny Committee, he took the chance to reach out by making contacts, talking about the issue and convincing people that they should join in and act as the all-party group does here, and I will do the same every time I go abroad. When Members who are listening to the debate are in contact with parliamentarians in other parts of Europe and beyond, they should talk not just about the positive things, but about the need to come together to shut down that
	network and protect the people who are exploited from country to country, for whatever reason. That will defend the people on our streets and in our communities much more than thinking that we can do it alone.

Gavin Williamson: That is a great tragedy, and it is common not just in food manufacturing. So many of the products that we see on the shelves of so many retailers right across the country are passed off as British when actually they are not. They are often manufactured to far lower standards. We have to take a lead on this issue.
	I must confess that when I got this debate my heart fell slightly. In my heart of hearts I know that the Minister will probably not quite be able to give me answers that I so desperately want to hear coming from his lips—that he is a passionate believer in country of origin markings and that this is something that we will roll out as a Government, helping manufacturing businesses large and small, right across the country. I had a look through something that the Department for Business, Innovation and Skills had produced setting out some of its concerns. I know that the Minister always listens closely to Members of Parliament, as we want to guide him away from the sometimes, let us say, constraining influence of officials and give him some exciting information to go back and challenge them with.
	One thing that officials constantly say is that the benefits to consumers are questionable. I cannot understand how any official could ever say that the benefits to consumers were questionable, when all that we would be doing is telling them where products come from. What could be more pure, more innocent or more helpful to consumers than telling them about the integrity of the products that they are buying—that is, about whether they are right and true—or where they have come from? Officials will probably say that country of origin marking will increase costs. I assure the Minister that it will not, for the simple reason that companies that are significant producers in furniture manufacturing, domestic appliances, chinaware, glassware or other sectors will already have to do country of origin labelling if they want to export into the US, Japan, South Korea and China. I remember exporting an awful lot of chinaware to China, and I always had to put the country of origin on the product. There is therefore no extra cost to manufacturers, because we already do it.
	I spoke just this morning to the chief executive of Royal Crown Derby, Hugh Gibson. I said to him, “Why do you want this country of origin marking?” and he said to me, simply, “Gavin, on every piece of ware that I produce, I put my Royal Crown Derby back stamp on it, and proudly, ‘Made in England’.” He added, “Other producers put their back stamp on products but no country of origin. I can only assume that they are ashamed of where they produced that product.”

Mark Spencer: My hon. Friend the Member for South Norfolk (Mr Bacon) mentioned the pork industry. The United Kingdom Government introduced regulation of pork production which applied higher animal welfare standards to British pigs. By not labelling products that come from other parts of the European Union, we are effectively allowing meat from pigs that have been subject to poorer welfare standards to sit on shelves next to our pork and to command the same value.